Charlene D Dyer, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10079 Issued in NC

Practice address

5200 Park Rd
Charlotte, NC 28209

Phone

(866) 700-1606

Fax

(866) 388-5921

NPI assigned

Jan 6, 2010

Last updated

May 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Charlene D Wells Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sparc Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1396155834
  NPD (past)
• The Reese Collective, LLC

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1760957153
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1962732420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 218B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "866-700-1606",
            "fax_number": "866-338-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28209",
            "telephone_number": "866-700-1606",
            "fax_number": "866-388-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "CHARLENE",
        "middle_name": "D",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-06",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121328",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "WELLS",
            "middle_name": "D",
            "credential": "MA LPCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jerry Brooks Dye Jr.
• Lauren Breedlove Dye, MS, LCMHC
• Adrian Dyer
• Anthony Lee Dyer
• Benjamin F Dyer Jr., D.D.S.
• Emmet Hunter Dyer, MD
• George D. Dyer Jr., LCSW
• Heather A Dyer, PH.D.
• Jessica Caroline Dyer
• Katherine Elizabeth Dyer, MMS, MS, PA-C

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.